Active NPI
Christine Zafra Mendoza, DMD
- Dentist
- Sun Prairie, WI
National Provider Identifier
1285479246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6001620-15
- Practice address
- 119 Wilburn Rd
Sun Prairie, WI 53590-1443 - Phone
- (608) 318-4330
- NPI assigned
- Jul 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6001620-15 | WI | Primary |
Addresses
Primary practice location
119 Wilburn Rd
Sun Prairie, WI 53590-1443
Mailing address
641 W Main St Apt 123
Sun Prairie, WI 53590-2955
Phone (630) 570-1377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6001620-15 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1285479246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "641 W MAIN ST APT 123",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535902955",
"telephone_number": "630-570-1377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 WILBURN RD",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535901443",
"telephone_number": "608-318-4330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "CHRISTINE",
"middle_name": "ZAFRA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-01",
"last_updated": "2024-07-01",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6001620-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.